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Cultural differences related to eating disorders and obesity

Source : Nutriactis/Rouen-Normandie hospital

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Summary

  • A fluctuating prevalence between regions of the globe
  • Some trails to explain these prevalences

A fluctuating prevalence between regions of the globe

Throughout history, eating disorders mainly affected developed countries such as Europe or North America especially teenage girls and young adults. However, this distribution evolved in the last few decades and today, eating disorders affect all continents. Indeed, according to recent data, the prevalence of all broad categories of eating disorders is:

17% in America (1)

13.7% in Europe (2)

11.5% in Asia (3)

  • America is the continent with the highest prevalence of eating disorders and especially binge eating disorders, which is very frequent. To the best of our knowledge, the prevalence of eating disorders in Africa has been few studied.
  • Regarding obesity, the prevalence is variable accross countries (see chart below) & depends on multiple factors such as lifestyle, diet…
  •  The actual prevalence is probably higher since those data were published in 2015 and a significant increase in obesity rate was observed these last few years. 

Figur 1 : Prevalence of obesity among adults over 20 years old according to countries in 2015 (Jaacks, 2019)

  • The prevalence data must be interpreted with caution. Indeed the diversity of studies in terms of classification, assessment tools and population studied can lead to multiple bias and make the comparison between studies difficult.

Some trails to explain these prevalences

The scientific literature has identified several trails to explain the difference in prevalence for these two diseases. Here is an overview:

1. Cultural and social context

The drive for thinness and body dissatisfaction are usually more frequent in Western countries compared to other countries of the world, which can be linked to differences in beauty standards. 

Moreover, recognition and acceptance of those pathologies, especially eating disorders, is variable across countries. Even though eating disorders are still taboo throughout the world, they are better known and accepted in western countries in comparison to Asia, for example, where denial is much more common . 

2. Lifestyle

Different lifestyles between countries constitute another factor explaining the disparity of prevalence.

Sedentary jobs or lack of physical activity can increase the risk of developing those pathologies. A sedentary lifestyle is more frequent in western countries but is expanding to the rest of the world.

3. Social networks

The excessive use of social networks is a risk factor for eating disorders. Yet, social networks are largely ubiquitous in developed countries, and are inscreasingly accessible and used in developing countries. 

4. Food

Accessibility and quality of food vary across countries and can be a risk factor of eating disorders and obesity.

For example, access to high fat and/or high sugar diet (often-industrial food) can promote the onset of binge eating disorder or obesity. On the other hand, the rejection of “junk food” can induce orthorexic behaviours and so encourage the emergence of inappropriate restrictive behaviours.

Focus on nutritional labels in Chil

Various prevention actions and legislations have emerged in some countries in order to reduce the consumption of industrial products. 

For example in Chile, neutral nutritional labels have been created with the sentence “Too high in…” followed by “sugar”, “salt”, “saturated fats” or “calories” depending on the product. Those labels had a massive impact on the population’s eating habits and especially on the consumption of sugary drinks such as soft drinks. Indeed, in two years, these measures have led to a 23.7% reduction in the volume of soft drinks purchased .